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WHO’s latest attack on nicotine pouches prompted backlash from both the nicotine industry and harm reduction advocates. Photo credit Olavi Rantala, CC2.0
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WHO’s recent report on nicotine pouches focuses largely on marketing practices rather than toxicology. Photo credit: Jonathan Cooper, Pexels.
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WHO estimates that about 160 countries lack nicotine pouch-specific regulations, including 16 that ban the products outright and 32 that regulate them to some extent. Photo credit: Mmmaaarrrttt, CC4.0.
The World Health Organization (WHO) has pushed nicotine pouches straight into the middle of the tobacco-control firestorm.
A new WHO publication, Exposing Marketing Tactics and Strategies Driving the Global Growth of Nicotine Pouches, is its toughest take yet on a fast-growing oral nicotine category. The report says companies are borrowing from the old cigarette playbook, using lifestyle branding, online influencer, sports tie-ins, and flavors, all aimed at driving sales across borders. WHO frames the spread as an immediate public health problem, especially in places where rules are thin or nonexistent.
“Governments are seeing the use of these products spread quickly, especially among adolescents and young people who are being aggressively targeted by deceptive tactics,” said Etienne Krug, director of the WHO Department of Health Determinants. “These products are engineered for addiction.”
That language landed like a match in dry grass. Pushback came quickly from parts of the nicotine industry and from harm-reduction advocates who argue the report blurs the line between nicotine and smoking. Derek Yach, a former WHO director and tobacco harm reduction expert, offered one of the sharpest rebukes.
Asked for his initial reaction, Yach said he felt extreme disgust. In his view, WHO should support nicotine pouches as substitutes for far more dangerous combustible tobacco use, pointing to Sweden and Iceland, as well as Indonesia and Pakistan, where he says nicotine pouches are displacing higher-risk products.
“Gutkha use is soaring in India, driving oral cancer among the poorest. Kretek (clove) cigarette use exceeds 65% in Indonesia. These two countries include the 2nd and 3rd largest number of smokers and tobacco users,” he said. “An ethically and scientifically grounded policy would encourage tobacco users to switch or quit [smoking combustibles by] using nicotine pouches. Not raise doubts. The toxic profile of [nicotine pouches] is almost identical to NRTs, which the WHO endorses.”
Chris Howard, executive vice president for external affairs and new product compliance at Swisher International, the parent of the Rogue nicotine pouch brand, also rejected the WHO’s report, especially its framework concerning dual use.
“We disagree with the suggestion that nicotine pouches inherently promote continued smoking or simply normalize nicotine use without supporting meaningful movement away from combustible cigarettes,” Howard said. “The more important public health question is whether adult smokers are migrating away from the highest-risk products, namely combustible cigarettes, and the available evidence increasingly suggests that many are.”
Howard cited a 2024 Rogue-sponsored study of adult smokers who used Rogue nicotine pouch, gum, and lozenge products. He said nearly two-thirds of the 1,393 participants who completed the six-month study either quit or significantly reduced their combustible use, and 13.3% reported they had stopped smoking entirely by the end.
Trade groups piled on as well. The Global Institute for Novel Nicotine (GINN) sent a joint statement to Tobacco Asia, signed by Shem Baldeosingh and several GINN members and advisors. Their message was mixed: they agreed on strong youth protections and responsible marketing rules but argued that WHO dodged the core question of whether pouches can help adults quit cigarettes.
“The WHO’s framing misses a critical distinction: the difference between nicotine use and smoking,” the group wrote. “By treating nicotine pouches primarily as another expression of tobacco industry harm, the report underplays their potential role for adults who smoke and need lower-risk alternatives.”
Laura Leigh Oyler, vice president of regulatory affairs at Nicokick.com, sharply criticized WHO’s conclusions, calling the report alarmist and disconnected from what regulators have already been doing in the US. She cited years of US Food and Drug Administration reviews covering toxicology, behavior, youth use patterns, and manufacturing.
“The latest FDA data shows youth use remains low, while population studies indicate that nicotine pouch users are overwhelmingly current or former users of cigarettes, smokeless tobacco, or vapes,” Oyler said. “These [nicotine pouches] are not products attracting large numbers of young people or new users. They are being used primarily by adults who already consume nicotine and are looking for lower-risk alternatives.”
Dr. Jamie Hartmann-Boyce, an assistant professor of health policy and management at the University of Massachusetts Amherst, said the central issue remains combustion. “There is a large, strong body of evidence showing that giving people who smoke nicotine in another form can help them quit smoking,” she said. “This is important because nicotine is not the ingredient in cigarettes that causes cancer, so moving people off of cigarettes onto another form of nicotine can reduce health risks.”
Regarding pouches specifically, she said the evidence is still developing. “We don’t yet have enough evidence on whether oral nicotine pouches can help people quit smoking, but large, independently funded studies are underway.”
The clash highlights an increasingly bitter divide over how governments should regulate smoke-free nicotine products, especially those that may pose dramatically lower toxicological risk than cigarettes while still raising concerns about addiction and youth exposure.
Smoke without fire
The WHO report devotes far more time to marketing than to toxicology. Over and over, it argues that pouch brands are recycling “tobacco industry playbooks” once tied to cigarettes and later to vaping. The report covers fruit and candy flavors, Formula 1 sponsorships, influencer partnerships, and “anytime, anywhere” messaging centered on discreet use.
It also targets words like “clean,” “modern,” “pure,” and “tobacco-free,” arguing that they can create a false sense of safety. A key section tracks how major tobacco multinationals have aggressively moved into pouches as cigarette sales decline. Philip Morris International now owns ZYN, the largest global nicotine pouch brand, through its acquisition of Swedish Match. British American Tobacco continues to expand VELO. Altria markets on!.
WHO repeatedly suggests that these strategies can steer people toward dual use rather than a full switch. Discreet-use messaging is a major target, with slogans such as “Anytime, anywhere,” “No smoke, no vapor,” and “More convenient, less noticeable,” which WHO says can normalize nicotine in places where smoking and vaping are restricted.
“Co-marketing is designed to increase revenue by encouraging dual (or poly) use,” the report states.
Howard argued that dual use should not be taken as proof that the product failed. Switching is rarely instant, and many smokers step down gradually, cutting back on cigarettes before leaving them behind. “Regulatory and public health frameworks should account for real-world consumer behavior rather than assuming every adult smoker will quit nicotine entirely in a single step,” he said.
Harm-reduction advocates, including Considerate Pouchers UK and We Vape, accused WHO of spreading misinformation, saying that “no smoke” is simply accurate. “Nicotine pouches do not produce smoke or smell, and pretending otherwise is scientifically absurd,” said Richard Crosby, director of Considerate Pouchers UK, who described the report as part of a “broad, aggressive anti-nicotine ideology.”
WHO also flags nicotine strength and delivery design. It says concentrations vary sharply across brands and markets, with some products promoted at 50 mg to 150 mg, and with nicotine salts and other approaches used to improve absorption and soften harshness. Yet critics argue that the report repeatedly sidesteps the most important scientific distinction in the entire nicotine debate: combustion.
GINN stressed that point. “Cigarettes kill because tobacco is burned, and smoke contains thousands of toxicants, with more than 70 documented carcinogens,” the statement said. “While nicotine is addictive and not risk-free, it is not a notable cause of smoking-related cancer, lung disease, or cardiovascular mortality.”
Public agencies, including the US FDA, have said non-combustible products generally expose users to fewer toxicants than cigarettes. FDA has also publicly stated that evidence suggests nicotine pouches are “far less harmful than tobacco and even other alternatives, like vapes.”
The burden of truth
The WHO report gives little weight to that FDA posture. Instead, critics argue that WHO often treats nicotine dependence and smoking-related disease as the same public health problem. Industry voices say WHO’s tone is shifting toward treating any positive messaging about smoke-free products as deception by default.
That criticism reflects broader frustration within segments of the nicotine industry. GINN warned that if governments place all nicotine products into a single category, the outcome could be perverse. “If governments regulate nicotine pouches as though they pose risks comparable to cigarettes, they may unintentionally protect the cigarette market and encourage smoking by making lower-risk alternatives less accessible, less acceptable, or less accurately understood,” the group wrote.
Howard echoed that point, arguing that regulation needs to distinguish between combustible and noncombustible products. “The scientific evidence overwhelmingly demonstrates that nicotine pouches present a materially different risk profile than combustible cigarettes,” he said. He reiterated that pouches avoid combustion, smoke inhalation, and exposure to many of the toxicants most strongly linked to smoking-related illness.
Howard also cited prior FDA language: “FDA itself has recognized that adults who completely switch from cigarettes to nicotine pouches may significantly reduce their exposure to harmful and potentially harmful constituents (HPHCs).”
Manufacturers and harm-reduction advocates argue that the WHO report pays too little attention to adult smokers who might use pouches to quit cigarettes. Prof. Caitlin Notley, a professor of addiction sciences at the University of East Anglia, said the report overstates the “no evidence” line on cessation.
“The WHO report is a comprehensive report on oral nicotine pouches,” she said. “It suggests that claims that nicotine pouches are helpful smoking cessation aids are unsubstantiated. This is not quite accurate, as there is emergent evidence of the potential role of nicotine pouches for smoking cessation.”
Notley pointed to her group’s review of more than 20,000 YouTube comments about pouches. People described using pouches to move away from smoking and, in some cases, from vaping. She described this as exploratory but said it shows that lower-harm consumer options can help some people.
WHO repeatedly returns to flavors, branding, and online campaigns. Critics counter that locking down communication about relative risk can strengthen cigarettes by keeping adult smokers in the dark and reducing legal competition. Meanwhile, WHO’s best case rests on messy regulation. Pouches have spread into markets with uneven rules and weak enforcement. WHO argues that many products arrived after tobacco-control systems were established, leaving gaps that companies could exploit through tweaks, online sales, and formulation changes.
WHO estimates that about 160 countries still lack pouch-specific frameworks. Sixteen countries ban pouches outright, and 32 regulate them to some extent. The result is a patchwork of tight controls in one place and near-total freedom in another. Even many harm-reduction supporters acknowledge that the category needs tougher standards: manufacturing rules, clearer nicotine labeling, environmental impact assessments, child-resistant packaging, and meaningful enforcement against youth-targeted marketing.
Dr. Harry Tattan-Birch, a senior research fellow at University College London, said WHO was right to highlight the loopholes. “The WHO report shows the wide-reaching ways in which nicotine pouch companies are trying to sell their products, including in ways that may appeal to young people, and how these products have fallen between the cracks of existing legislation,” he said. “Because they do not contain tobacco leaf, and are not vapes, they have often not been covered by tobacco- or vape-specific rules.”
The fault line
The fight ultimately boils down to a single policy choice: should nicotine be regulated primarily by addiction risk or by risk relative to combustible smoking? WHO’s report leans strongly to-ward precaution. Its recommendations amount to one of the most aggressive global wish lists for pouches: flavor bans, ad limits, nicotine caps, plain packaging, social-media controls, and higher taxes.
Critics say that set of tools could backfire. Flavors are the biggest pressure point. WHO says flavors attract kids. Industry voices argue that flavors help adult smokers leave cigarettes be-hind and stick with a lower-risk option, the same argument that has shaped the vaping battles worldwide.
Some in the industry also say WHO’s approach could shield cigarettes, making pouches less appealing, less available, and harder to discuss legally. Tattan-Birch agreed that bans can be counterproductive. “Nicotine pouches do not produce smoke or require inhalation into the lungs, meaning they are likely to be substantially less harmful to health than cigarettes,” he said. “But an outright ban on nicotine pouches, while cigarettes remain widely available, could be counterproductive for public health.”
Howard called for “risk-proportionate” regulation that respects the distinct toxicology of smoke-free oral nicotine while maintaining scientific scrutiny. In practice, he said, this means focusing premarket review on chemistry, manufacturing, toxicology, ingredients, and product quality, while addressing longer-term behavioral or clinical questions through post-market surveillance and targeted studies.
“That does not mean reduced scientific standards or reduced oversight,” he said. “Rather, it means focusing regulatory review on the issues most relevant to the actual risks presented by the product category.”
Others warn that heavy advertising limits can create space for illicit sellers who ignore the rules. Countries with strict vape restrictions have already seen illicit disposable vape markets grow, and GINN warned that prohibition-style approaches can fail when they do not distinguish cigarettes from lower-risk alternatives. Instead, the group advocated strict youth protection, clear nicotine labeling, manufacturing standards, real age verification, and evidence-based communication on relative risk.
Harm-reduction advocates say relative risk still carries weight until better data arrives. Tattan-Birch described the balancing act: reducing appeal and access for kids and for people who would not otherwise use nicotine, while keeping the door open for adults who smoke and might benefit. He also urged caution regarding cessation claims.
“The recent Cochrane review found that the current evidence is too limited and uncertain to conclude that nicotine pouches help people quit smoking,” he said. “More studies are needed.” Sweden remains the reference point in these arguments. In the US, FDA has authorized multiple ZYN and on! PLUS pouch products via the PMTA pathway. France has moved to broadly ban oral nicotine products, including pouches. Swedish officials have criticized the French move, saying it dismisses Sweden’s harm-reduction record and dis-proportionately affects smoke-free oral products relative to cigarettes.
GINN cited early data from Saudi Arabia indicating that pouches are used primarily by existing nicotine users as a harm-reduction or cessation tool, not as a major gateway. The group reported that 56% of users in the available Saudi market data reported quitting smoking, while also noting that stronger long-term evidence is still required.
Sweden’s widespread use of smoke-free oral nicotine has coincided with some of Europe’s lowest smoking rates and the lowest smoking-related disease burden. Critics argue that WHO treats Sweden primarily as a growth market for pouches rather than as a real-world case study in harm reduction.
A workable path may lie between WHO’s hardline instincts and industry’s sales goals. That middle ground, neither prohibition nor a free-for-all, may shape the future of nicotine pouch regulation. Howard warned that piling on heavy burdens can slow progress in harm reduction. “Requiring every lower-risk product to satisfy the same evidentiary expectations as combustible cigarettes can create unnecessary barriers that slow innovation, delay adult access to potentially less harmful alternatives, and divert regulatory resources away from the highest-risk products,” he said.
He argued that effective policy should maintain rigorous scientific over-sight while providing a practical pathway for the review, authorization, and monitoring of lower-risk products. The biggest unknown is not whether nicotine pouches are harmless; they probably are not. The real issue is whether regulated, smoke-free nicotine options can reduce smoking-related disease more quickly than prohibition-style policies.
WHO answers that question cautiously and skeptically. The nicotine industry and harm-reduction advocates say the science speaks for itself and that reducing the public health impacts of combustibles should be the ultimate goal. As nicotine pouch use spreads, governments will decide which view sets the tone for the next decade of tobacco policy.